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At least 1,027 records · Page 57Linked to original sources
PubMed1997

Prosthetic weight acceptance mechanics in transtibial amputees wearing the Single Axis, Seattle Lite, and Flex Foot.

Loading response challenges the limb with the dual demands of accepting rapidly moving body weight to both absorb the shock of floor contact and create a stable limb over which the body can advance. Delay in achieving foot flat contact with the floor causes a prolonged period of heel only support and results in an unstable base of support for those persons with transtibial amputations. The purpose of this study was to identify mechanical causes of instability during weight acceptance with three different prosthetic foot designs, Single Axis, Seattle Lightfoot, and Flex Foot. Ten male individuals with transtibial amputations were tested on three separate occasions wearing each prosthetic foot. A comparison group of ten individuals without transtibial amputations was also examined. Mean free walking speed was significantly slower for those with transtibial amputations regardless of the prosthetic foot worn (p < 0.05). Contralateral toe off times were significantly later for each prosthetic foot (p < 0.01). The timing of peak knee flexion was found to be significantly later than normal for each prosthetic foot (p < 0.01). To minimize the impact of initial floor contact, persons with an intact limb used rapid plantar flexion, followed by a slower lowering of the foot to the floor. Dorsiflexion then stimulated knee flexion and foot flat. Two altered functions were found for all three prosthetic feet, reduced knee flexion and prolonged heel only support. Diminished knee flexion reflected delayed dorsiflexion and tibial advancement as a result of the cushioned heel. Lateness in reaching foot flat was also found. To improve the walking abilities of those persons with transtibial amputations, prosthetic foot designs need to incorporate mechanisms which promote early foot flat while preserving limb stability.

Aged↗
PubMed1990

Analysis of below-knee suspension systems: effect on gait.

Seven different suspension systems for below-knee prostheses were tested on 20 adult, unilateral amputees. All subjects walked with a prosthesis. Gait was evaluated with regard to longitudinal and vertical accelerations of the body, forward velocity, axial (piston) movement of amputated limb in the socket, and knee movement. Harmonic analyses of variable waveforms provided the primary method to discriminate performances among the suspensions. The appropriateness of a given suspension system depended on both the length and the shape of the residual limb.

Adult↗
PubMed1998

New hands reduce handicap.

PURPOSE: This case study concerns Mr AH, a 93 year old man who suffered bilateral traumatic transcarpal amputations at the age of 17. METHOD: His presentation and the prescription of cosmetic hand prostheses illustrate several interesting points. RESULTS: These include that advanced age and lengthy period since amputation do not preclude prosthetic provision. CONCLUSIONS: Bilateral upper limb amputees can lead long, productive and fulfilling lives and the psychological benefits of cosmetic prostheses are of primary concern in the upper limb amputee.

Activities of Daily Living↗
PubMed1963

Habilitation of patients with congenital malformations associated with thalidomide: surgery of limb defects.

The deformities commonly seen in "thalidomide babies" are described. These vary from relatively uncomplicated radial-ray defects to complete phocomelia of all four extremities. It is suggested that the care of these children is best carried out in a clinic accustomed to dealing with juvenile amputee problems. A plea is made for very early fitting of upper-extremity prostheses (at approximately three months of age) in cases of unilateral upper-limb deficiencies. A "bucket" for sitting should be supplied for children with quadrilateral phocomelia to sit in when they reach seven or eight months of age. Children with severe upper-limb malformations will be candidates for some form of externally powered prostheses.

Adolescent↗
PubMed1995

The effect of five prosthetic feet on the gait and loading of the sound limb in dysvascular below-knee amputees.

The purpose of this study was to determine the effects of prosthetic foot design on the vertical ground reaction forces experienced by the sound and amputated limbs in a group of persons with dysvascular below-knee amputations. Stride characteristics, joint motion, and ground reaction forces were recorded simultaneously during a self-selected free walking velocity in seven subjects wearing five different prosthetic feet (SACH, Flex-Foot, Carbon Copy II, Seattle, Quantum). Subjects used each foot for one month prior to testing. Results indicated that the sound limb was exposed to higher vertical ground reaction forces than normal despite a reduced walking velocity. Use of the Flex-Foot resulted in the lowest sound limb vertical forces, which appears to be related to its large arc of dorsiflexion motion. In addition, there was increased loading response knee flexion of the sound limb indicating an attempt by these subjects to modulate floor impact. These results suggest that the intact lower extremity is susceptible to excessive floor impact, and that prosthetic foot design can have an effect on the magnitude of the vertical forces experienced by the limb.

Aged↗
PubMed1999

A survey of function in children with lower limb deficiencies.

Function and prosthesis technical problems were surveyed in 258 experienced paediatric lower-limb prosthesis wearers. The two-part survey form consisted of the modified Prosthesis Evaluation Scale and the core module of the American Academy of Orthopaedic Surgeons/Council of Musculoskeletal Specialty Societies (AAOS/COMSS) Lower Limb Outcomes instrument. Eighty-eight percent (88%) of these paediatric subjects were able to wear their prosthesis more than 9 hours/day; only 3 subjects (1%) were not able to wear their limb at all. The average distance walked per day was reported to be 5.24 kilometres. Sixteen percent (16%) reported pain as "moderate" or worse. A majority reported not having a problem with perspiration, however, 20% had problems serious enough to limit prosthesis wearing time significantly. The most common reasons for temporary loss of limb use were pain (62 responses) and prosthesis failure (59 responses), followed by tissue breakdown (42 responses) and perspiration (30 responses). In general, the paediatric population achieves full use at a high rate, is much more active than the adult population, and experiences less limb pain.

Adolescent↗
PubMedDate not supplied

Normative ground reaction force data for able-bodied and below-knee-amputee children during walking.

We determined normative ground reaction force data for able-bodied (AB) and below-knee-amputee (BKA) children during walking. Twenty-two BKA and 225 able-bodied children walked over two adjacent force platforms. Average normalized force-time curves were determined for legs of the children for subjective comparisons, and discrete variables were determined for statistical comparisons. No significant differences existed between (a) right and left legs, (b) gender, and (c) age for the AB children. BKA children had an asymmetrical gait pattern with a dominant role of the nonprosthetic limb. This dominant role was related to a greater rate of loading, magnitude of loading, impulse, and time of loading as compared with prosthetic limbs and with the limbs of AB children.

Adolescent↗
PubMedDate not supplied

Skin and bone integrated prosthetic pylon: a pilot animal study.

Direct skeletal attachment of limb prostheses is a viable alternative to traditional techniques that are based on a socket-residuum interface. Direct skeletal attachment may be a better or even the only method for patients with a very short residuum and high soft-tissue volume. The problem of integrating the prosthetic pylon with residual skin during direct skeletal attachment of a limb prosthesis has not been solved, and the use of a completely porous prosthetic pylon has not been the subject of focused, systematic research. In this in vivo study, we investigated cell (osteocyte, fibroblast, and keratinocyte) adhesion and penetration into the pores of a titanium pylon implanted in Wistar rats. The porous titanium pylon was implanted in the bone of the thigh residua of four rats. Electronic scanning and morphological analysis demonstrated integration of the pylon with the surrounding skin. These findings support the possibility of developing a natural barrier against the infection associated with direct skeletal attachment of limb prostheses.

Animals↗
PubMed1981

Persistent phantom limb pain.

The role of psychological factors in 10 patients with painful phantom limbs was investigated by means of a questionnaire and interviews. The hypotheses were that the severity of pain would be positively correlated with their present personal problems and attitudes and with experience of pain in the limb before amputation. The first hypothesis was confirmed but the second was not.

Adaptation, Psychological↗
PubMed2001

Sports and recreation for persons with limb deficiency.

UNLABELLED: Opportunities for persons with limb deficiency to participate in sport and recreational activities have increased dramatically over the past 20 years. Various factors have contributed to this phenomenon, including an increased public interest in sports and fitness as well as improvements in disability awareness. An even more essential element has been a consumer-driven demand for advances in prosthetic technology and design. Whether the activity is a music performance, a friendly round of golf, or a high-level track-and-field competition, the benefits of participation in sports and recreation are numerous both at the individual and at the societal level. This article provides an overview of the development and scope of sport and recreational opportunities available to persons with limb deficiency. In addition, specific prosthetic considerations for several common sport and recreational activities are presented in a case-discussion format. OVERALL ARTICLE OBJECTIVE: To review the development and scope of sport and recreational opportunities available to persons with limb deficiency.

Adolescent↗
PubMed1996

Mechanical work adaptations of above-knee amputee ambulation.

OBJECTIVE: To quantify the muscular adaptations of above-knee amputee patients' ambulation using an experimental and modeling approach. DESIGN: Nonrandomized controlled study. SETTING: A referral center for treatment of veterans with amputation. SUBJECTS: Eight normal ambulators and 8 nondysvascular above-knee amputee subjects wearing the same lightweight prostheses were studied with a gait analysis system, walking at self-selected speeds. MAIN OUTCOME MEASURES: Using an inverse dynamics linked segment model, the mechanical torque, power output, and work done were calculated at the hip, knee, and ankle joints. RESULTS: The mean concentric ankle plantarflexor work done was much greater for the normal subjects compared to the prosthetic limb in pushoff (25.2 +/- 3.7 J vs 4.9 +/- 2.1 J), but greatest for the intact limb of the amputee subjects (34.2 +/- 6.6 J). Also, the concentric hip extensor work done in early stance was greater for the intact limb of the amputee subjects than for normal subjects (9.9 +/- 5.5 J vs 3.6 +/- 2.6 J), presumably compensating for the coincident decreased pushoff of the prosthetic limb. Other compensatory mechanisms are also discussed. CONCLUSIONS: Increased joint torques and power outputs of the amputee subjects' intact limb compared to normal ambulation may be viewed as providing additional gait progression and upright stance during parts of the gait cycle when the amputated limb lacks needed active muscle support.

Adaptation, Physiological↗
PubMed1999

Toddlers with limb deficiency: conceptual basis and initial application of a functional status outcome measure.

OBJECTIVE: To describe the conceptual foundation, development, and initial psychometric analyses of a new outcome measure of functional status in toddlers with limb deficiency. DESIGN: Parents of children with limb deficiency completed self-report measures during a routine medical clinic visit. SETTING: Outpatient orthopedic pediatric clinic. PARTICIPANTS: Twenty parents (mothers) of children (ages 1 to 4 years) with acquired or congenital limb deficiency. MAIN OUTCOME MEASURE: The newly developed Child Amputee Prosthetics Project-Functional Status Inventory for Toddlers (CAPP-FSIT). RESULTS: Estimates of internal consistency reliability of the measure are high, suggesting conceptual congruence among the items. Initial validity studies confirm the CAPP-FSIT differentiates between toddlers with upper limb deficiency and lower limb deficiency in terms of functional activity and prosthesis use. The new measure does not appear to be contaminated by gender or socioeconomic status. CONCLUSION: The CAPP-FSIT is a promising measure for assessing functional abilities in toddlers with limb deficiency.

Activities of Daily Living↗
PubMed2000

Skin disorders in amputees.

BACKGROUND: Dermatologic problems restrict the normal use of a prosthetic limb. The importance of contact dermatitis to skin morbidity in a population of amputees and the selection criteria for patch testing have not been clearly defined. OBJECTIVE: We describe the range of dermatoses seen in a population of amputees and examine the incidence, causes, and patterns of contact dermatitis. METHODS: This is a questionnaire-based, cross-sectional study of 210 amputees. Those with a skin problem were assessed by a dermatologist. Patch testing was undertaken in patients with persistent dermatitis. RESULTS: A total of 34% of amputees experienced a skin problem. Lesions resulting from friction, pressure, and occlusion are common. Allergic contact dermatitis is seen in a third of patients with stump dermatitis. There are no features that distinguish allergic from irritant (chemical or physical) dermatitis. CONCLUSION: Dermatologic problems are common in prosthetic limb users. Allergic contact dermatitis is a significant problem, and all patients with dermatitis on the residual limb should be patch tested.

Amputation, Surgical↗
PubMed2005

Demography and function of children with limb loss.

This retrospective study was designed for the period 1982-2002 to collect the basic data on the demography, level and side of the amputation, involved limbs, age, gender, and prosthetic functional level in children with limb loss. A total of 232 children were assessed through their prosthetic records. Seventy-two percent (195 children) presented lower-limb involvement, and 28% (77 children) had upper-limb loss. The age of the children varied between 1 and 15 years with a mean age of 9.90 +/- 2.32 years. Results of the study revealed that the leading amputation cause in children was congenital limb absence. The most frequent levels were determined as trans-tibial and trans-radial in lower and upper limbs, respectively. Findings showed that more boys (60%) were affected, and 84% of all amputations were found to be unilateral. It was also seen that right-side amputations (54%) were more common than left-side amputations (46%). The outcome of the study showed that 96% of children with lower-limb loss reached a functional gait pattern without any aids, while the percentage of independence in activities of daily living was found to be 88% in upper-limb loss.

Accidents, Traffic↗